How to Coach Yourself and Others Empowering Coaching And Crisis Interventions | Page 167

This book is in B&W, not color - Print page in Grayscale for Correct view! Risk Level Intervention AUDIT score (*) Zone I Alcohol Education Zone II Simple Advice Zone III Simple Advice plus Brief Counseling and Continued Monitoring Zone IV Referral to Specialist for Diagnostic 0-7 8-15 16-19 20-40 Evaluation and Treatment The AUDIT cut-off score may vary slightly depending on the country’s drinking patterns, the alcohol content of standard drinks, and the nature of the screening program. Clinical judgment should be exercised in cases where the patient’s score is not consistent with other evidence, or if the patient has a prior history of alcohol dependence. It may also be instructive to review the patient’s responses to individual questions dealing with dependence symptoms (Questions 4, 5 and 6) and alcohol-related problems (Questions 9 and 10). Provide the next highest level of intervention to patients who score 2 or more on Questions 4, 5 and 6, or 4 on Questions 9 or 10. Total scores of 8 or more are recommended as indicators of hazardous and harmful alcohol use, as well as possible alcohol dependence. (A cut-off score of 10 will provide greater specificity but at the expense of sensitivity.) Since the effects of alcohol vary with average body weight and differences in metabolism, establishing the cut off point for all women and men over age 65 one point lower at a score of 7 will increase sensitivity for these population groups. Selection of the cut-off point should be influenced by national and cultural standards and by clinician judgment, which also determine recommended maximum consumption allowances. Technically speaking, higher scores simply indicate greater likelihood of hazardous and harmful drinking. However, such scores may also reflect greater severity of alcohol problems and dependence, as well as a greater need for more intensive treatment. The AUDIT questionnaire: choosing a cut-off score. Conigrave KM, Hall WD, Saunders JB. Source Centre for Drug and Alcohol Studies, Royal Prince Alfred Hospital, New South Wales, Australia. Abstract Three hundred and thirty ambulatory care patients were interviewed using a detailed assessment schedule which included the AUDIT questions. After 2-3 years, subjects were reviewed and their experience of alcohol-related medical and social harm assessed by interview and perusal of medical records. AUDIT was a good predictor of both alcohol-related social and medical problems. Cut-off points of 7-8 maximized discrimination in the prediction of trauma and hypertension. Higher cut-offs (12 and 22) provided better discrimination in the prediction of alcohol-related social problems and of liver disease or gastrointestinal bleeding, but high specificity was offset by reduced sensitivity. We conclude that the recommended cut-off score of eight is a reasonable approximation to the optimal for a variety of endpoints. (PMID: 8616463 - [PubMed - indexed for MEDLINE] More detailed interpretation of a patient’s total score may be obtained by determining on which questions points were scored. In general, a score of 1 or more on Question 2 or Question 3 indicates consumption at a hazardous For [email protected] Property of Bookemon, do NOT distribute 167